tetano
Editor, Senior Moderator
Influenza Other Respir Viruses
. 2024 Sep;18(9):e13354.
doi: 10.1111/irv.13354. Associations Between Severe Influenza-Complicated Thromboembolism Events, Intensive Care Unit Stays and Mortality, and Associated Risk Factors: A Retrospective Cohort Study
Wei-Chun Lee[SUP] 1 [/SUP], Che-Chia Chang[SUP] 1 [/SUP], Meng-Chin Ho[SUP] 1 [/SUP], Chin-Kuo Lin[SUP] 1 [/SUP], Chieh-Mo Lin[SUP] 1 [/SUP], Yu-Hung Fang[SUP] 1 [/SUP], Shu-Yi Huang[SUP] 1 [/SUP], Yu-Ching Lin[SUP] 1 2 3 [/SUP], Min-Chun Chuang[SUP] 1 [/SUP], Tsung-Ming Yang[SUP] 1 [/SUP], Ming-Szu Hung[SUP] 1 2 3 [/SUP], Yen-Li Chou[SUP] 1 [/SUP], Ying-Huang Tsai[SUP] 4 5 [/SUP], Meng-Jer Hsieh[SUP] 4 5 [/SUP]
Affiliations
The association between influenza infection and thromboembolism (TE) events, including cardiovascular events, cerebrovascular events, pulmonary embolism, and deep vein thrombosis, is supported by compelling evidence. However, there is a disparity in the risk factors that impact the outcomes of severe influenza-complicated TE in intensive care unit (ICU) patients. The objective of this study was to evaluate the outcomes of severe influenza-complicated TE in ICU patients and identify any associated risk factors.
Methods: A retrospective cohort study was conducted, recruiting consecutive patients with TE events admitted to the ICU between December 2015 through December 2018 at our institution in Taiwan. The study included a group of 108 patients with severe influenza and a control group of 192 patients with severe community-acquired pneumonia. Associations between complicated TE, length of ICU stay, and 90-day mortality were evaluated using logistic regression analysis, and risk factors were identified using univariate and multivariate generalized linear regression analyses.
Results: TE event prevalence was significantly higher in ICU patients with severe influenza than in ICU patients with severe CAP (21.3% vs. 5.7%, respectively; p < 0.05). Patients with severe influenza who developed TE experienced a significant increase in the ratio of mechanical ventilation use, length of mechanical ventilation use, ICU stay, and 90-day mortality when compared to patients without TE (all p < 0.05). The comparison of severe CAP patients with and without TE revealed no significant differences (p > 0.05). The development of thromboembolic events in patients with severe influenza or severe noninfluenza CAP is linked to influenza infection and hypertension (p < 0.05). Furthermore, complicated TE and the severity of the APACHE II score are risk factors for 90-day mortality in ICU patients with severe influenza (p < 0.05).
Conclusions: Patients with severe influenza and complicated TE are more likely to have an extended ICU stay and 90-day mortality than patients with severe CAP. The risk is significantly higher for patients with a higher APACHE II score. The results of this study may aid in defining better strategies for early recognition and prevention of severe influenza-complicated TE.
Keywords: community‐acquired pneumonia; influenza; intensive care stay; mortality; risk factors; thromboembolism disease.
. 2024 Sep;18(9):e13354.
doi: 10.1111/irv.13354. Associations Between Severe Influenza-Complicated Thromboembolism Events, Intensive Care Unit Stays and Mortality, and Associated Risk Factors: A Retrospective Cohort Study
Wei-Chun Lee[SUP] 1 [/SUP], Che-Chia Chang[SUP] 1 [/SUP], Meng-Chin Ho[SUP] 1 [/SUP], Chin-Kuo Lin[SUP] 1 [/SUP], Chieh-Mo Lin[SUP] 1 [/SUP], Yu-Hung Fang[SUP] 1 [/SUP], Shu-Yi Huang[SUP] 1 [/SUP], Yu-Ching Lin[SUP] 1 2 3 [/SUP], Min-Chun Chuang[SUP] 1 [/SUP], Tsung-Ming Yang[SUP] 1 [/SUP], Ming-Szu Hung[SUP] 1 2 3 [/SUP], Yen-Li Chou[SUP] 1 [/SUP], Ying-Huang Tsai[SUP] 4 5 [/SUP], Meng-Jer Hsieh[SUP] 4 5 [/SUP]
Affiliations
- PMID: 39192663
- PMCID: PMC11350130
- DOI: 10.1111/irv.13354
The association between influenza infection and thromboembolism (TE) events, including cardiovascular events, cerebrovascular events, pulmonary embolism, and deep vein thrombosis, is supported by compelling evidence. However, there is a disparity in the risk factors that impact the outcomes of severe influenza-complicated TE in intensive care unit (ICU) patients. The objective of this study was to evaluate the outcomes of severe influenza-complicated TE in ICU patients and identify any associated risk factors.
Methods: A retrospective cohort study was conducted, recruiting consecutive patients with TE events admitted to the ICU between December 2015 through December 2018 at our institution in Taiwan. The study included a group of 108 patients with severe influenza and a control group of 192 patients with severe community-acquired pneumonia. Associations between complicated TE, length of ICU stay, and 90-day mortality were evaluated using logistic regression analysis, and risk factors were identified using univariate and multivariate generalized linear regression analyses.
Results: TE event prevalence was significantly higher in ICU patients with severe influenza than in ICU patients with severe CAP (21.3% vs. 5.7%, respectively; p < 0.05). Patients with severe influenza who developed TE experienced a significant increase in the ratio of mechanical ventilation use, length of mechanical ventilation use, ICU stay, and 90-day mortality when compared to patients without TE (all p < 0.05). The comparison of severe CAP patients with and without TE revealed no significant differences (p > 0.05). The development of thromboembolic events in patients with severe influenza or severe noninfluenza CAP is linked to influenza infection and hypertension (p < 0.05). Furthermore, complicated TE and the severity of the APACHE II score are risk factors for 90-day mortality in ICU patients with severe influenza (p < 0.05).
Conclusions: Patients with severe influenza and complicated TE are more likely to have an extended ICU stay and 90-day mortality than patients with severe CAP. The risk is significantly higher for patients with a higher APACHE II score. The results of this study may aid in defining better strategies for early recognition and prevention of severe influenza-complicated TE.
Keywords: community‐acquired pneumonia; influenza; intensive care stay; mortality; risk factors; thromboembolism disease.